Endodontic Radiology
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Includes Credits
CE Hours: 0.75
Description: Managing large cystic periapical lesions presents significant challenges for clinicians, especially when non-surgical treatment or retreatment options prove ineffective. Surgical intervention involving debridement and apical resection may be deemed contraindicated due to factors such as the proximity to vital anatomical structures, the risk of damage to adjacent teeth, and compromised healing associated with significant bony defects. Despite these challenges, decompression offers a minimally invasive treatment alternative that is frequently overlooked in modern dentistry. This presentation aims to explore the indications and advantages of decompression in treating large cystic periapical lesions. Through clinical case studies and follow-ups, we will demonstrate essential steps, including pre-operative assessment using cone-beam computed tomography (CBCT) scans, needle aspiration-irrigation techniques, and the placement of a Penrose drain. Furthermore, we will review pertinent literature to highlight the biological principles, clinical efficacy, and long-term outcomes associated with decompression.
Learning Objectives:
- Describe the clinical indications for decompression and conduct a preoperative assessment using conebeam computed tomography (CBCT) scans.
- Perform aspiration irrigation techniques and utilize a Penrose drain for decompression.
- Evaluate the outcome of decompression in treating large cystic periapical lesions.
Feng-Ming Wang, D.D.S., Ph.D.
Dr. Wang is a diplomate of ABE and currently teaches at Texas A&M University College of Dentistry. He maintains private practice limited to Endodontics in Dallas, TX.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 0.75
Description: Radiographic imaging requires recognition of typical anatomic structures and distinction from a vast array of pathologic processes. Accurate diagnostic assessment often entails recognizing normal and abnormal radiographic features coincident with synthesizing clinical and available historical information. When clinicians are confronted with interpreting various radiographic curiosities and unusual disease presentations, pulp vitality testing is crucial to determine correct pulp and periapical diagnoses, followed by appropriate treatment. Several examples of diagnostic challenges and radiographic oddities mimicking periradicular lesions of endodontic origin, culled from the records of the presenter’s 35 years of practice, will be exhibited and discussed. Several cases displaying anomalous oral findings and referred for endodontic treatment were diagnosed as malignant conditions and subsequently treated successfully, thanks to accurate and timely endodontic diagnoses.
Learning Objectives:
- Evaluate radiographic oddities with clinical skepticism.
- Perform thorough and accurate pulp vitality tests to treatment plan oral diseases appropriately.
- List and discuss nonodontogenic conditions mimicking radiographic lesions of endodontic origin.
Michael J. Ribera, D.MD, M.S.
Dr. Ribera is a 1984 graduate of Boston College and a 1989 graduate of Harvard School of Dental Medicine. In 1990, he completed a general practice residency at Harvard’s Brigham and Women’s Hospital, and in 1992 received his Certificate in Endodontics and Master of Science Degree from Northwestern University Dental School in Chicago.
Dr. Ribera is a Diplomate of the American Board of Endodontics, a member of the Endodontic College of Diplomates, a specialist member of the American Association of Endodontists, and a Fellow of the International College of Dentists. He is the 2006 recipient of the District of Columbia Dental Society’s David Mast Memorial Award for excellence in continuing education. Dr. Ribera is in full-time practice and maintains three offices in the Washington, D.C. Metro Area.Speaker Disclosure
I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.
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Includes Credits
CE Hours: 1.0
Description: This lecture will discuss novel rolls CBCT plays in endodontics beyond basic diagnosis. Topics include technological advances, dynamic navigation, augmented reality, and guided procedures.
Learning Objectives:
- Describe the advantages of CBCT use in endodontics.
- Talk about novel uses of CBCT in the endodontic practice.
- Describe where the future is headed for CBCT use in the endodontic practice.
Christopher D. Matesi, DDS
Christopher Matesi is an oral and maxillofacial radiologist based out of Napa, California. He is originally from Chicago, IL and graduated from University of Illinois Chicago College of Dentistry in 2012. He practiced general dentistry in a private practice setting for 7 years doing many different types of procedures including endodontics, implant placement and prosthodontics. His found his love was really in the diagnostics, treatment planning and technological aspects of dentistry. Radiology fit all those things perfectly and in 2019 and he began his oral and maxillofacial radiology residency at University of Florida. There he was selected as chief resident during his PGY2 year and completed his OMR residency training in December of 2021. Out of residency he started his practice, Dental Imaging Diagnostics, with the goal of providing customized radiology reporting that highlights areas of importance that are clinically useful for the practicioner. He also provides surgical guides for a number of different surgical procedures including implant placement and endodontic guidance. He tries to incorporate the latest technical advances in his practice in order to make the clinician's already difficult job just a little easier and more predictable. Outside of his practice, he likes to spend time with his lovely wife and son, golf and go to wine tastings now that he just moved to wine country.
Disclosure(s): Dental Imaging Diagnostics: Ownership Interest (stocks, stock options, patent or other intellectual property or other ownership interest excluding diversified mutual funds) (Ongoing)
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Includes Credits
CE Hours: 0.75
Description: Artificial Intelligence (AI) has been widely discussed as one of the most significant disruptors of current times. While the use of generative AI, such as Chat GPT, has been a hot topic in education, other applications of AI have substantially impacted the dental industry as well. Clinical decision support tools, such as Overjet, analyze digital images to identify periapical radiolucencies, caries, and bone levels. This session will present a dental school’s experience using an AI-powered clinical decision support tool in a comprehensive clinical care model to improve the identification of endodontic lesions, optimize patient flow, and impact educational outcomes. Attendees will gain insights into the practical application of these tools, potential challenges, and benefits, ultimately aiming to elevate the quality of endodontic education and patient care.
Learning Objectives:
- Describe the fundamentals of artificial intelligence and its relevance to endodontic practice.
- Identify the functionalities and capabilities of Overjet as a clinical decision support tool in endodontics.
- Apply strategies for leveraging AI technologies in endodontic curricula to enhance student learning and clinical outcomes.
Keith R. Boyer, D.D.S
Dr. Keith Boyer is an Associate Professor at Western University of Health Sciences and a Diplomate and Director of the American Board of Endodontics. He received his D.D.S. from University of the Pacific Arthur A. Dugoni School of Dentistry and his specialty certificate in endodontics from University of Pennsylvania School of Dental Medicine. After residency he practiced endodontics in Philadelphia while teaching at the university. He has also practiced in California. He was drawn back into the academic environment because of his desire for continuous learning and to share that knowledge with colleagues and future dentists. He has been teaching clinical and pre-clinical endodontics full-time at WesternU since 2013. Dr. Boyer has given presentations locally and nationally and published multiple articles in peer-reviewed journals.Speaker Disclosure
I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.
Alexander Lee, D.M.D.
Dr. Lee is a General Dentist, Professor, and the Assistant Dean for Dental Informatics at Western University of Health Sciences College of Dental Medicine (WesternU). His primary role is to design and develop innovations to increase the efficiency of educational and clinical operations. His current research interests focus on artificial intelligence, mixed reality, the cognitive science for learning, and formative assessments. He is a regular contributor to the Journal of the California Dental Association and the Journal of Dental Education. Dr. Lee received his Doctor of Dental Medicine from the University of Pittsburgh School of Dental Medicine and is an active member of the American Dental Education Association where he is a member of the Policy and Research Advisory Committee. He is a fellow of the Pierre Fauchard Academy, a fellow of the American College of Dentists, and an alumnus of the ADEA Leadership Institute.
Speaker Disclosure
I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.
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Includes Credits
CE Hours: 0.75
Description: Prevention and/or elimination of pulpal pathology and apical periodontitis is the ultimate goal of endodontic treatment. The success rate of primary non-surgical root canal treatment is >90%.Root canal retreatment might also fail or may not be feasible, on those cases root end surgery is the procedure of choice in those cases. The success rate of the micro-surgery was reported to be (94%) as shown in the systematic review and meta-analysis by Setzer et al. Despite its very high success, micro-surgery may be difficult to perform in certain cases. The combination of artificial intelligence (AI) and digital workflow has the potential to revolutionize endodontics. AI can be used to improve diagnosis, treatment planning, and patient care, while digital workflow can improve efficiency and accuracyIn this lecture, the advancement of AI and digital workflow in the field of Endodontic microsurgery, intentional replantation , and autotransplantation will be discussed, including the use of guided and navigation systems technology to perform the highest standard procedure with a predictable outcome.
Learning Objectives:
- Learn how to use artificial intelligence (AI) to improve the diagnosis and treatment planning.
- Perform precise and accurate guided Root-end surgeries.
- Discuss the use of digital workflows in Endodontics to maximize the outcome of Auto transplantation for different clinical presentations.
Mohammed A. Alharbi, B.D.s, D.Sc.D
Dr. Mohammed Alharbi is an assistant Professor at the Endodontic department at King Abdulaziz University, Jeddah, Saudi Arabia. And Adjunct Assistant professor at the University of Pennsylvania school of Dental Medicine. Dr. Alharbi received his BDS Degree from King Abdulaziz University in 2009 with an Honor Degree. Dr. Alharbi completed his Endodontic postgraduate training at the University of Pennsylvania in 2014 , Doctor of Science in Dentistry (DScD) from the University of Pennsylvania in 2017, and Executive MBA from Prince Mohammed Bin Salman College for business administration and entrepreneurship.
He is a Diplomate of the American Board of Endodontics. He received Hatton research award from the IADR in 2017, The Young Investigator award from the AADR mineralized tissue group 2017, and the KAU Dean’s researcher award for the faculty with the highest impact factor in 2019 and 2020. He is currently in the editorial board of the Journal of dental research (JDR) and published many articles in peer reviewed journals. Dr. Alharbi lectures nationally and internationally as a member of Penn Endo Global Symposium team.Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 0.75
Description: The dental pulp is a singular connective tissue confined by rigid walls of mineralized tissue in an environment that has a low tolerance to inflammation, where the tissue is supplied by the blood vessels passing through the apical foramen. An arborized vascular system and a delicate artery that penetrates the apical foramen represent its only blood source. Orthodontic movement may cause a great number of tissue alterations in the dental pulp, however, these changes may not be entirely recognized owing to the difficulty in simulating clinical situations. Depending on the duration, type and magnitude of the force, and the physiological tissue tolerance, the pulp tissue may be affected in a reversible or irreversible manner. This presentation will discuss with clinical cases and scientific evidence these alterations and how to deal with the diagnostic procedure.
Learning Objectives:
- Discuss using scientific evidence and clinical cases, the pulpal alterations that can occur during orthodontic treatment.
- Describe common orthodontic-endodontic treatment planning challenges.
- Describe an appropriate management of teeth requiring integrated endodontic and orthodontic treatment (i.e sub-epithelial cervical root resorption).
Rodrigo S. Cunha, D.D.S., M.Sc., Ph.D.
Dr. Rodrigo Sanches Cunha completed his Undergraduate Dental Degree in 1994, which he obtained from the Catholic University of Campinas in Sao Paulo - Brazil. His post-graduate studies include a Specialty degree in Endodontics obtained in 1997 from the State University of Campinas (UNICAMP); in 2002, a M.Sc. degree in Clinical Dentistry (Endodontics), and in 2006, a Ph.D. degree in Dental Sciences both of which he received from Sao Leopoldo Mandic Centre for Dental Research. Dr. Cunha was an Associate Professor at the Catholic University of Campinas from 2001 until 2011. On September 9, 2011, Dr. Cunha moved with his wife (Andressa) and three daughters (Leticia, Larissa and Helena) to Winnipeg to work as a Full-time Professor at the College of Dentistry, Faculty of Health Sciences at the University of Manitoba. Dr. Cunha became Fellow of the Royal College of Dentists of Canada (Endodontics) in 2013 and, in 2016, decided to work in Private Practice full-time. Dr. Cunha is the Co-founder of Prairie Endodontics in 2018. Dr. Cunha has been a guest speaker at more than 200 events worldwide. He has published more than 50 papers and abstracts in several peer reviewed journals. In addition, Dr. Cunha has published six book chapters and has extensive clinical experience obtained working in Private Practice limited to Endodontics since 1995. Dr. Rodrigo Cunha is the President of the Canadian Academy of Endodontics (CAE).
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.25
Description: Endodontics is about more than saving teeth. It is easy to assume that any radiolucency associated with pain is of pulpal origin, especially if the tooth has a significant restorative history. However, numerous non-inflammatory pathologies of variable clinical significance can be identified in the periapical region. Differentiating the typical endodontic presentation from that of a more insidious etiology is of critical importance to ensure ideal management and outcome. Additionally, intra-oral examination should include a screening of the soft tissues for any abnormalities related to the dental pulp. A thorough evaluation of the soft tissues may result in the identification of pathologies not related to pulp inflammation. These changes can be reactive or neoplastic requiring timely and appropriate management to ensure the best prognosis. This discussion, based exclusively on clinical cases, will cover a variety of soft tissue and bone abnormalities to review the most relevant oral pathologies every endodontist needs to know.
Learning Objectives:
- Incorporate a systematic method to formulate a differential diagnosis of radiographic lesions found in the periradicular areas.
- Describe the growth pattern of soft tissues lesions to help differentiate reactive from neoplastic.
- Discuss the radiographic changes consistent with non-inflammatory etiologies and recognize when referral for biopsy is indicated.
David J. Landwehr, D.D.S., M.S.
Dr. David Landwehr earned his D.D.S. at the University of Minnesota. He received an M.S. degree and certificate in oral and maxillofacial pathology at The Ohio State University followed by specialty training in endodontics at the University of Michigan. Dr. Landwehr has been a private practice clinician for more than twenty years and for the last nine years has provided exemplary patient care at Capital Endodontics in Madison, WI.
Dr. Landwehr’s ongoing work as an educator and opinion leader has positioned him at the forefront of modern endodontic treatment. Dr. Landwehr authored the chapter titled Lesions That Mimic Endodontic Pathosis for the most recent edition of Cohen’s Pathways of the Pulp and was the Chief of Endodontics for the Meriter Hospital general practice residency for more than ten years. He has lectured extensively on endodontic diagnosis and oral pathology both nationally and internationally. His teaching focuses on techniques used daily in his clinical practice that are efficient, predictable and evidence based.
Disclosure(s): Surround Medical: Ownership Interest (stocks, stock options, patent or other intellectual property or other ownership interest excluding diversified mutual funds) (Ongoing), Speaker/Honoraria (includes speakers bureau, symposia, and expert witness) (Ongoing)
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Includes Credits
CE Hours: 1.0
Description: Computer Guided Endodontic Solutions for Complex Cases. With the introduction of cone beam computed tomography (CBCT), intra-oral scanning, 3D planning software, 3D printers and computer aided dynamic navigation devices, It is possible to plan ahead, in a very precise, predictable, more conservative way computer aided procedures with lower clinical times for high difficulty cases, such as, severely calcified canals, endodontic microsurgery of cases with intact cortical bone close to important anatomical structures like the maxillary sinus, the mental foramen or the mandibular canal, and tooth autotransplantation of both mature or immature teeth. The necessary digital work flow for static 3D-printed guides or dynamic virtual guides and the available scientific evidence will be discussed in detail as well as the clinical protocols and required armamentarium. Several clinical cases of each type of guided treatment will be shown and described step by step with proper follow up periods displaying a positive outcome.
Learning Objectives:
- List the digital work flow necessary to perform computer aided endodontic treatments.
- Evaluate if a specific case is indicated, or not, to be treated with a computer aided or guided procedure.
- Discuss the possibility of offering these types of treatments to a patient.
Felipe Restrepo, D.D.S. M.Dent
Dr. Felipe Restrepo, was born and raised in Medellín - Colombia. Graduated from the University of Antioquia with a degree in Dentistry 2003, after one year as general practicioner he entered a two year Endodontic program and graduated from University CES in 2007. Associate Professor at the University of Antioquia teaching their postgraduate level students in endodontics and also Director of the Dental Emergencies Diploma. Dr. Restrepo has authored several scientific articles in peer-reviewed journals. Ex-president of the Antioquian Association of Endodontists. Private practice limited to Endodontics, Endodontic Microsurgery and Tooth Autotransplantation in Medellín since 2007, international speaker.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.25
Description: ULTRASOUNDS REAL TIME IMAGING (USI) is and advanced complement in endodontic diagnostic techniques. Ultrasound real-time imaging, (echography ), widely used in most fields of medicine since its introduction in 1942, is based on the generation and reflection of ultrasound waves and on the different mechanical and acoustic properties of body tissues. USI does not use ionizing radiations, and thus it represents a safe exam. The most important features of USI are its safety and its ability to describe the content of the lesions within the maxillary bones, in terms of presence of solid tissue, different fluids and vascularity. The use of USI has been successfully applied to the endodontic field for the DETECTION and DESCRIPTION of apical periodontitis, for the DIFFERENTIAL DIAGNOSIS between CYSTIC and SOLID lesions of endodontic origin, and between endodontic lesions and non-endodontic lesions; and also for evaluating the short and long term outcome of orthograde and surgical endodontic treatment. An integrated system of CBCT and USI would provide the clinician with the tools for the complete assessment of apical periodontis.
Learning Objectives:
- Describe the imaging technique called Ultrasound real-time examination, its main features and its biological safety.
- Describe the most important advantages of using Ultrasound real-time examination when applied to the visualization and description of lesions of apical periodontitis in the mandible and in the maxillary bone, their content and vascularization.
- Describe the advantages of using Ultrasound real-time examination, as a complement to 3D radiographic examination, to differentially diagnose bone lesions with fluids or solid content, high, low, or no vascularity, to trace sinus tracts.
Elisabetta Cotti, D.D.S., M.S.
Elisabetta Cotti, DDS, MS, received her DDS from the University of Cagliari – Italy and the specialty and MS in Endodontics from the University of Loma Linda- California.
She is Full Professor of Conservative Dentistry and Endodontics, and the Chairman of the Department of Conservative Dentistry and Endodontics at the School of Dentistry, University of Cagliari- Italy. She is currently the Director of the Post Graduate programme (Master) in Clinical Endodontics at the University of Cagliari, lecturer in the Department of Endodontics at Loma Linda University, USA. She is the president of IFEA (International federation of Endodontic Associations). She practices limited to Endodontics, and is author of several articles and chapters in the field of Endodontics with has a specific interest in apical periodontitis, imaging and trauma.
Disclosure(s): Dentsply Sirona Endodontic SBU: Honorarium (Ongoing), serve as consultant in products development and as lectures (Ongoing)
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Includes Credits
CE Hours: 1.5
Description: Join us for a review of some large and significant pathologies, their clinical presentation, imaging features, and discussion of management.
Learning Objectives:
- Describe cases of large pathologies in the maxillofacial region
- Explain some of the imaging techniques and radiographic features of large pathology in the maxillofacial region
- Identify the clinical significance and management strategy of large pathology in the maxillofacial region
Laurence Gaalaas, D.D.S., M.S.
Dr. Gaalaas received his dental degree from the University of Minnesota and completed specialty training and a Master of Science degree in oral and maxillofacial radiology from the University of North Carolina at Chapel Hill. As a researcher and inventor, his expertise includes clinical applications of cone beam computed tomography, caries detection and diagnosis, and development of novel imaging techniques specific to dentistry such as low dose 3D intraoral radiography and dental MRI. He is a Diplomate of the American Board of Oral and Maxillofacial Radiology, a member of the American Academy of Oral and Maxillofacial Radiology, and has ongoing teaching responsibilities plus an active radiology practice through the University of Minnesota and RAYUS Radiology.
Speaker Disclosure
I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.
Jacob Yetzer, D.D.S., M.D.
Dr. Jacob Yetzer is an Oral and Maxillofacial Surgeon with subspecialty focus on Head and Neck Oncology and Reconstruction. He currently practices both in the private setting in Minneapolis, Minnesota and serves as adjunct factulty at the University of Minnesota and North Memorial Health Hospital. Dr. Yetzer has served as faculty in Oral and Maxillofacial Surgery at both Mayo Clinic and the University. Dr. Yetzer's publications and lectures have included a wide range of topics in the arena of Head and Neck Surgery and Reconstruction. His peer-reviewed literature and other chapters describe clinical pathways for the management of oncology patients, oral cancer, reconstruction of oromandibular defects, microvascular reconstruction of complex defects of the maxillofacial region, thyroid surgery, simultaneous whole-arch dentoskeletal reconstruction and use of technology in maxillofacial oncology patients. Dr. Yetzer completed his fellowship in Head and Neck Oncology and Microvascular Reconstruction at the University of Florida-Jacksonville in 2015. He also completed his medical training and residency at this same institution. He completed his dental training at Pacific University in 2008.
I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.